Preliminary Research On Two-step Dosing Of Imipenem/Cilastatin

NCT ID: NCT02616354

Last Updated: 2015-11-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-01-31

Study Completion Date

2015-12-31

Brief Summary

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Explore Imipenem/Cilastatin two-step dosing compared to 2 hours infusion in patients with severe whether can obtain better results of the pharmacokinetic/pharmacodynamic, for clinical rational use of antimicrobial agents, and provide theoretical support for optimizing dosage regimen.

Detailed Description

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Compared with Imipenem/Cilastatin 2 hours continuous dosing method and two-step dosing method (0.5 hours before enter half dose, after 1.5 hours, the other half of the input dose) of blood drug concentration in the body than the minimal inhibitory concentrations (MIC) pathogens percent of dosing interval duration (100% fT \> MIC), blood drug concentration in the body more than 4 times the minimal inhibitory concentrations (MIC) pathogens percent of dosing interval duration (100% fT \> 4 MIC), blood drug concentration peak and the ratio of the minimal inhibitory concentrations (MIC) pathogens (Cmax/MIC), blood drug concentration (Tmax) used in the peak time, used to guide clinical patients with severe infection of Imipenem/Cilastatin usage.

Conditions

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Sepsis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Group I

Group I received intravenous imipenem/cilastatin 1 g every 8 h (q8h) or 0.5g every 6 h (q6h) with optimized two-step infusion therapy (OTIT; rapid first-step infusion in 30 min and slow second-step infusion above 1.5 hours) "Group I" is more informative than "Group II" from PK parameters(%T\>MIC,AUC/MIC).

Group Type ACTIVE_COMPARATOR

Imipenem

Intervention Type DRUG

Patients in group I received a dose of imipenem/cilastatin 1g each every 8 hours or 0.5g every 6 hours optimized two-step infusion therapy (rapid first-step infusion in 30 min and slow second-step infusion above 1.5 hours)

Group II

group II received intravenous imipenem/cilastatin 1g q8h or 0.5g q6h with extended infusion therapy (2-hours continuous infusion in a constant speed).

"Group I" is more informative than "Group II" from PK parameters(%T\>MIC,AUC/MIC).

Group Type PLACEBO_COMPARATOR

Imipenem

Intervention Type DRUG

Patients in group I received a dose of imipenem/cilastatin 1g each every 8 hours or 0.5g every 6 hours optimized two-step infusion therapy (rapid first-step infusion in 30 min and slow second-step infusion above 1.5 hours)

Interventions

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Imipenem

Patients in group I received a dose of imipenem/cilastatin 1g each every 8 hours or 0.5g every 6 hours optimized two-step infusion therapy (rapid first-step infusion in 30 min and slow second-step infusion above 1.5 hours)

Intervention Type DRUG

Other Intervention Names

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Optimized two-step infusion therapy

Eligibility Criteria

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Inclusion Criteria

* sepsis or severe sepsis or severe infections in the previous 48 hours
* treatment with imipenem/cilastatin (recommended by hospital microbiologists)
* expected duration of hospital stays in the ICU ≥ 72 h from recruitment
* recruited patients agreed to participate in this trial, and had set up a signed informed consent

Exclusion Criteria

* with an allergy to carbapenems or with an adverse drug reaction to imipenem
* acute or chronic renal failure assessed by serum creatinine concentrations \> 280 μmol/L (or creatinine clearance \<20mL/min) or those requiring continuous renal replacement therapy
* drug or alcohol abuse
* Pregnant and lactant women
* patients near to death
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Merck Sharp & Dohme LLC

INDUSTRY

Sponsor Role collaborator

Southeast University, China

OTHER

Sponsor Role lead

Responsible Party

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Jianfeng Xie

Deputy director of the physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Kang Xu

Nanjing, Jiangsu, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Kang Xu, master

Role: CONTACT

+8615851836872

Facility Contacts

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Kang Xu

Role: primary

+86 15851836872

References

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Huang Y, Xu K, Zhan Y, Zha X, Liu S, Xie J, Liu L, Li Q, Shao H, Yang Y. Comparable Effect of Two-Step Versus Extended Infusions on the Pharmacokinetics of Imipenem in Patients with Sepsis and Septic Shock. Adv Ther. 2020 May;37(5):2246-2255. doi: 10.1007/s12325-020-01339-5. Epub 2020 Apr 10.

Reference Type DERIVED
PMID: 32277344 (View on PubMed)

Other Identifiers

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Two-step Dosing Of Imipenem

Identifier Type: -

Identifier Source: org_study_id